Web-Based Middle School HIV Prevention Curricula: Aspiring for Reach & Impact Early adolescent sexual behavior is a significant public health problem in the U.S. Few programs, however, have proven effective in delaying sexual behavior among middle school students, and many have limited potential for wide-scale dissemination. This investigative team has developed and evaluated a new HIV, STI and pregnancy prevention classroom and computer-based program, entitled It's Your Game...Keep it Real (IYG). We found IYG to be effective in delaying sexual initiation among youth after long term follow-up. This evaluation was based on student's participation in both the classroom and computer-based components. To increase its dissemination potential, determining the relative long-term effectiveness of the computer-based component as a standalone curriculum has become an important next step in the field, as this examines additional avenues for prevention. We recently converted all of the IYG computer activities to an Internet-based platform. An Internet version of the IYG computer-based component incorporates technological advances and the appeal of the Internet for youth, which may have the potential to bolster effects, improve lesson fidelity, and facilitate dissemination in a cost-effective manner. In a small pilot study of this Internet program, students exposed to the program were more likely to report positive effects on psychosocial factors related to risky sexual behavior. These findings need to be replicated in a larger trial; thus, this 3-year study proposes to evaluate this Internet-based HIV, sexually transmitted infection (STI), and pregnancy prevention curriculum as a standalone intervention for middle school students in a large urban school district. A randomized two-arm nested design will be conducted with 1,600 middle school students where schools receiving the Internet-based curriculum (n=7 schools) will be compared with comparison schools receiving usual care (n=7). This study builds on extensive prior research in this domain and will contribute to our understanding of using the Internet to deliver an HIV, STI, and pregnancy prevention program to middle school students. PUBLIC HEALTH RELEVANCE: Narrative Description The use of computers, games, and the Internet to address adolescent sex education is a burgeoning research area. An Internet-based HIV, STI, and pregnancy prevention program for middle school students has the potential for low-cost, high fidelity dissemination, if it is proven to be effective at delaying sexual initiation.